PDF(Pubmed)
Abstract：
UNASSIGNED: A surgical simulation of an endoscope-dominated side-to-end hypoglossal-facial anastomosis was performed to evaluate the feasibility.
UNASSIGNED: Eight anatomical cadaver heads (16 sides) were recruited. The steps in conventional procedures were abbreviated or omitted. A facial nerve was first harvested near its external genu and was used for a side-to-end hypoglossal-facial anastomosis. The stump of the used facial nerve was truncated and recycled immediately caudal to the facial recess in another anastomosis and then recycled again at the stylomastoid foramen. As a recycled stump becomes too short to ensure a side-to-end anastomosis, the hypoglossal nerve was transected in situ, and an endoscopic end-to-end hypoglossal-facial anastomosis was attempted. Surgical simulation and quantitative measurement methods were used to analyze the anastomosis effects of different harvested sites of the facial nerve.
UNASSIGNED: Several steps in the conventional procedures provide little benefit in endoscopic surgery. A facial nerve stump recycled at the stylomastoid foramen is too short to ensure a tensionless side-to-end anastomosis. An endoscopic end-to-end hypoglossal-facial anastomosis was feasible, although it required more time than the classical microsurgical anastomosis. The greater agility of an endoscope enables the conventional surgical steps to be overlapped or interweaved into the procedure.
UNASSIGNED: The multiple surgical fields and ability to manipulate the viewpoint provided by an endoscope have brought about breakthroughs in classical surgical paradigms. In addition, it is best to choose the sites of the facial nerve harvested near the external genu. If unavailable, an alternative section site could be selected immediately caudal to the facial recess, but cannot be distal to the stylomastoid foramen. The length of the stump should be individualized and preferably optimized with a nerve stimulator.
UNASSIGNED: Eight anatomical cadaver heads (16 sides) were recruited. The steps in conventional procedures were abbreviated or omitted. A facial nerve was first harvested near its external genu and was used for a side-to-end hypoglossal-facial anastomosis. The stump of the used facial nerve was truncated and recycled immediately caudal to the facial recess in another anastomosis and then recycled again at the stylomastoid foramen. As a recycled stump becomes too short to ensure a side-to-end anastomosis, the hypoglossal nerve was transected in situ, and an endoscopic end-to-end hypoglossal-facial anastomosis was attempted. Surgical simulation and quantitative measurement methods were used to analyze the anastomosis effects of different harvested sites of the facial nerve.
UNASSIGNED: Several steps in the conventional procedures provide little benefit in endoscopic surgery. A facial nerve stump recycled at the stylomastoid foramen is too short to ensure a tensionless side-to-end anastomosis. An endoscopic end-to-end hypoglossal-facial anastomosis was feasible, although it required more time than the classical microsurgical anastomosis. The greater agility of an endoscope enables the conventional surgical steps to be overlapped or interweaved into the procedure.
UNASSIGNED: The multiple surgical fields and ability to manipulate the viewpoint provided by an endoscope have brought about breakthroughs in classical surgical paradigms. In addition, it is best to choose the sites of the facial nerve harvested near the external genu. If unavailable, an alternative section site could be selected immediately caudal to the facial recess, but cannot be distal to the stylomastoid foramen. The length of the stump should be individualized and preferably optimized with a nerve stimulator.
摘要：
■进行了内窥镜为主的侧到端舌下面吻合术的手术模拟，以评估可行性。
■招募了8个解剖尸体头部（16侧）。常规程序中的步骤被缩写或省略。首先在其外部生殖器附近收获了面神经，并将其用于舌下面侧吻合术。将使用过的面神经的残端截短，并在另一个吻合中立即向后回收到面部隐窝，然后在茎乳孔再次回收。由于回收的残端变得太短，无法确保侧端吻合，舌下神经原位切断,并尝试了内窥镜下端到端舌下面吻合术。采用手术模拟和定量测量方法，分析面神经不同收获部位的吻合效果。
■常规程序中的几个步骤在内窥镜手术中几乎没有益处。在茎乳孔处再循环的面神经残端太短，无法确保无张力的侧端吻合。内镜下端到端舌下面吻合术是可行的，虽然它需要更多的时间比传统的显微外科吻合术。内窥镜的更大的敏捷性使得常规的手术步骤能够被重叠或交织到手术中。
■内窥镜提供的多个手术视野和操纵视点的能力带来了经典手术范例的突破。此外,最好选择在外生殖器附近采集的面神经部位。如果不可用，可以立即在面部隐窝的尾部选择另一个切片部位，但不能在茎乳孔的远端。残端的长度应该是个性化的,并且优选地用神经刺激器来优化。
■招募了8个解剖尸体头部（16侧）。常规程序中的步骤被缩写或省略。首先在其外部生殖器附近收获了面神经，并将其用于舌下面侧吻合术。将使用过的面神经的残端截短，并在另一个吻合中立即向后回收到面部隐窝，然后在茎乳孔再次回收。由于回收的残端变得太短，无法确保侧端吻合，舌下神经原位切断,并尝试了内窥镜下端到端舌下面吻合术。采用手术模拟和定量测量方法，分析面神经不同收获部位的吻合效果。
■常规程序中的几个步骤在内窥镜手术中几乎没有益处。在茎乳孔处再循环的面神经残端太短，无法确保无张力的侧端吻合。内镜下端到端舌下面吻合术是可行的，虽然它需要更多的时间比传统的显微外科吻合术。内窥镜的更大的敏捷性使得常规的手术步骤能够被重叠或交织到手术中。
■内窥镜提供的多个手术视野和操纵视点的能力带来了经典手术范例的突破。此外,最好选择在外生殖器附近采集的面神经部位。如果不可用，可以立即在面部隐窝的尾部选择另一个切片部位，但不能在茎乳孔的远端。残端的长度应该是个性化的,并且优选地用神经刺激器来优化。
